Basic Information
| Provider Information | |||||||||
| NPI: | 1518900554 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HAYS | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | ANTHONY | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD, LAT, PES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3921 TACOMA ST | ||||||||
| Address2: | |||||||||
| City: | IRVING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750627238 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8177219241 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2801 LEMMON AVE STE 400 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752042399 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2143031033 | ||||||||
| FaxNumber: | 2143031032 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2006 | ||||||||
| LastUpdateDate: | 06/20/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/20/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | E-9484 | AR | N | Allopathic & Osteopathic Physicians | Family Medicine | 2255A2300X | AT1711 | TX | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Specialist/Technologist | Athletic Trainer | 207Q00000X | R3857 | TX | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | AT1711 | 01 | TX | ATHLETIC TRAINER | OTHER |